Abstract
This contribution on the biology and management of bone metastases from prostatic cancer is divided into three parts. The first details a study conducted at Stanford University on the prevention of bone metastases in the lumbar spine, in patients in whom the lumbar spine has been irradiated coincidental to the radiation treatment of the paraaortic lymph nodes. The incidence of metastases was significantly reduced in 71 patients in whom the apparently normal lumbar spine was irradiated, as compared to the incidence of metastases in 65 patients who received no lumbar irradiation. The implications of these observations on developing strategies for early, or preemptive, irradiation for bone metastases are discussed.
In the second part, the optimum radiation dose and fractionation scheme for the palliation of overt bone metastases is addressed. Drawing largely from the work of Arcangeli et al., a total dose of 40–50 Gy*, fractionated at 2 Gy per day, seems to be the regimen of choice for enduring pain relief for most patients with prostatic metastases to bone.
Finally, the recent utilization of strontium-89 in the palliation of advanced bone metastases is addressed.
The Gy is the current international unit of radiation. 1Gy = 100 Rad; 1cGy (centigray) = 1 Rad.
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References
Arcangeli G., Micheli A., Arcangeli G., Giannarelli D., et al., The responsiveness of bone metastases to radiotherapy: The effect of site, histology and radiation dose on pain relief, Radiother. and Oncol. 14:95–101 (1989).
Blitzer P.H., Reanalysis of the RTOG study of the palliation of symptomatic osseous metastasis, Cancer 55:1468–1472 (1985).
Jensen N.H. and Roesdahl K., Single dose irradiation of bone metastases, Acta Radiol. Then Phys. Biol. 15:337–339 (1976).
Penn C.R.H., Single dose and fractionated palliative irradiation for osseous metastases, Clin. Radiol. 27:405–408 (1976).
Tong D., Gillick L. and Hendrickson F.R., The palliation of symptomatic osseous metastases: Final results of the Radiation Therapy Oncology Group, Cancer 50:893–899 (1982).
Vargha Z.A., Glicksman A.S. and Boland J., Single dose radiation therapy in the palliation of metastatic disease, Radiobiology 93:1181–1184 (1969).
Hercbergs A., Werner A. and Brenner H.J., Reduced thoracic vertebrae metastases following post mastectomy parasternal irradiation, Int. J. Radiat. Oncol. Biol. Phys. 11:773–776 (1985).
Fletcher G.H., Subclinical disease, Cancer 53:1274–1284 (1984).
Kaplan H.S., Hodgkin’s Disease, Cambridge University Press, Cambridge (1972).
Dvorak H.F., Tumors: Wounds that do not heal-similarities between tumor stroma generation and wound healing, N. Engl. J. Med. 315:1650–1659 (1986).
Kumar S. and Arnold F., Can metastasis be restrained? in: “Breast Cancer: Treatment and Prognosis,” pp. 287–299, Stoll B.A., ed., Blackwell Scientific Publications, Palo Alto, CA (1986).
Kaplan I.D., Valdagni R., Cox R.S. and Bagshaw MA., Reduction of spinal metastases after preemptive irradiation in prostatic cancer, Int. J. Radiat. Oncol. Biol. Phys. 18:1019–1025 (1990).
Pistenma D.A., Bagshaw M.A. and Freiha F.S., Extended-field radiation therapy for prostatic adenocarcinoma: Status report of a limited prospective trial, in: “Cancer of the Genitourinary Tract,” pp. 229–243, Johnson D.E., Samuels M.L., eds., Raven Press, New York (1979).
Bagshaw M.A., Current conflicts in the management of prostatic cancer, Int. J. Radiat. Oncol. Biol. Phys. 12:1721–1727 (1986).
Bagshaw M.A., Cox R.S. and Ray G.R., Status of radiation treatment of prostate cancer at Stanford University, NCI Monographs, No. 7, p 47 (1988).
Hazra T.A. and Giri S., Prophylactic pelvic girdle irradiation in the treatment of prostatic carcinoma, Int. J. Radiat. Oncol. Biol. Phys. 7:817–819 (1981).
Netlund P.A. and Zehen B.R., Organ-specific adhesion of metastatic tumor cells in vitro, Science 224:1113–1114 (1984).
Nicolson G.L., Metastatic tumor cell attachment and invasion assay utilizing vascular endothelial monolayers, J. Histochem. Cytochem. 30:214–220 (1982).
Thomlinson R.H. and Gray L.H. Histologic structures of some human lung cancers and possible implication for radiotherapy, Br. J. Cancer 9:539–549 (1955).
Hirst D.G., Denekamp J. and Hobson B., Proliferation kinetics of endothelial and tumor cells in three mouse mammary carcinomas, Cell Tiss. Kin. 15:251–261 (1982).
Potsaid M.S., Irwin R. J. Jr., Castronova F.P., et al., 32P diphosphonate dose determination in patients with bone metastases from prostatic carcinoma, J. Nucl. Med. 19:98–104 (1978).
Tenvall J., Darte L., Lundgren R. and El Hassan A.M., Palliation of multiple bone metastases from prostatic carcinoma with strontium-89, Acta. Oncol. (Sweden), ISSN 02480-186X, 27(4) p. 365–369 (1988).
Kloiber R., Molnar C.P. and Barnes M., Sr-89 therapy for metastatic bone disease: Scintigraphic and radiographic follow-up, Radiol. 163:719–723 (1987).
Blake G.M., Zivanovic M.A., McEwan A.J. and Ackery D.M., Sr-89 therapy: Strontium kinetics in disseminated carcinoma of the prostate, Eur. J. Nucl. Med. 12:447 (1986).
Correns H.J., Mebel M., Buchali K., Schnorr D., et al., Strontium-89 therapy of bone metastases of carcinoma of the prostatic gland, Eur. J. Nucl. Med. 4:33 (1979).
Loevinger R. and Berman M., A schema for absorbed-dose calculations for biologically distributed radionuclides, MIRD, Pamphlet No. 1 (1968).
Snyder W.S., Ford M.R., Warner C.G. and Watson S.B., ‘S’, absorbed dose per unit cumulated activity for selected radionuclides and organs, MIRD, Pamphlet No. 11 (1975).
American International Booklet, 1985. Amersham product literature PLF, UK (1985).
Silberstein E.B. and Williams C., Strontium-89 therapy for the pain of osseous metastases, J. Nucl. Med. 26:345 (1985).
Kaplan E.L. and Meier P., Nonparametric estimation from incomplete observation, J. Am. Stat. Assoc. 53:457–481 (1958).
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Bagshaw, M.A., Kaplan, I.D., Valdagni, R., Cox, R.S. (1992). Radiation Treatment of Prostate Bone Metastases and the Biological Considerations. In: Karr, J.P., Yamanaka, H. (eds) Prostate Cancer and Bone Metastasis. Advances in Experimental Medicine and Biology, vol 324. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-3398-6_28
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DOI: https://doi.org/10.1007/978-1-4615-3398-6_28
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